FDA Adverse Event Other Summary report: N

LIFESTYLES SKYN

MDR report key: 2824525 · Received October 12, 2012

Report

Report Number
1019632-2012-00011
Event Type
Other
Date Received
October 12, 2012
Report Date
October 12, 2012
Manufacturer
SURETEX LTD.
Product Code
HIS
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

CUSTOMER INFORMED ANSELL HEALTHCARE PRODUCTS LLC THAT AFTER USING THE LIFESTYLES POLYISOPRENE LUBRICATED CONDOM, SHE HAD REPEATEDLY DEVELOPED (B)(6). SHE HAS VISITED HER REGULAR GYNECOLOGIST AND WAS PRESCRIBED THE FOLLOWING: (B)(6).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LIFESTYLES SKYN LUBRICATED POLYISOPRENE CONDOMS HIS SURETEX LTD. 1203100322

Patients

Seq Age Sex Outcome Treatment
1 Other